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Nutrition Flashcards

1
Q

Hormones of Digestive Tract

A

Gastrin-digests food, necessary for growth
Secretin-duodenum, stimulates stomach to produce enzymes/liver to produce bile, regulates water homeostasis
Cholecystokinin (CCK)-duodenum, causes pancreas to release enzymes, signals gallbladder, hunger suppressant

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2
Q

Body Mass Index (BMI)

A 
body weight/height^2
Underweight: <18.5
Overweight: 25-29.9
Obesity: >30
Morbid Obesity: >35 w/comorbidities OR BMI >40
Waist M: >40in F: >35in
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3
Q

Obesity Assessment

A 
H&amp;P
Fasting lipid profile
TSH
Fasting glucose &amp;HgbA1C
Liver enzymes
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4
Q

Risks for weightloss/malnutrition

A

9 D’s: dementia, depression, disease, dysphagia, disgeusia, diarrhea, drugs, dentition, dysfunction

Meals on wheels: medication effects, emotional probs, anorexia, late life paranoia, swallowing disorders, oral factors, no money, wandering/dementia, hyper/hypothyroidism, enteric probs, eating probs, low salt/cholesterol diet, social probs

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5
Q

Malnutrition

A

Need 2 or more:
-insufficient energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, localized/generalized fluid accumulation, diminished functional status (handgrip)

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6
Q

Anorexia

A

Decrease in appetite

Associated with poor emotional wellbeing, illness, drugs, dementia, mood disorder

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7
Q

Cachexia

A 
Hypercatabolic state by accelerated loss of skeletal muscle due to inflammatory response
involuntary weight loss more than 10%
Anorexia
Systemic inflammation
Sarcopenia
Fatigue
Imbalance of catabolism and anabolism
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8
Q

Sarcopenia

A

Loss of skeletal muscle, strength, performance
Underlying illness doesn’t have to be present
Nutritional deficiency
Insulin resistance

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9
Q

Malnutrition Risk

A

At risk if 1+ met:
unintentional weight loss more than 10% in last 3 months
Body weight <90% ideal for height
BMI <18.5

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10
Q

Protein Deficiency

A

Hollowing of temporal muscles
Wasting of upper arms/thighs
Esily plucked hair
Peripheral edema

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11
Q

Screening Tools

A

Nutritional Risk Screening (NRS)
Simplified Nutrition Assessment Questionnaire (SNAQ)
SCREEN II
Malnutrition universal screening tool (MUST)
Mini nutritional assessment (MNA)

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12
Q

Malnutrition markers

A
  • Mild: albumin 2.8-3.2, TS200-250, lymphocytes 1200-2000
  • Moderate: Al 2.1-2.7, TS 100-200, lympho 800-1200
  • Severe alb <2.1 TS<100 Lympho<800
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13
Q

Treatment for Weightloss

A

Treat underlying condition

Address inadequate food intake

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14
Q

Fat soluble vitamins

A

A, D, E, K

More toxic than water soluble in excess

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15
Q

Vitamin A

A

Retinol
Bile needed for absorption, stored in liver
Helps bone/tooth, skin/mucous membranes, dim light vision

Deficiency: night blindness, dry eyes, goose bump rash

Excess: liver damage/increased pressure on brain, vision changes, bone pain, rough skin/dry lips

Sources: Dark leafy green/yellow veggies, fortified dairy, liver

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16
Q

Vitamin D

A

Calcium hemostasis/bone metabolism/internal Ca/K absorption
Inhibited by glucocorticoids

Deficiency: Rickets, osteomalacia

Excess: anorexia, n/v, polydipsia, polyuria

Sources: fortified milk, fish liver oil, UV exposure, supplements

Recommended dose: 600IU/day

Best lab: serum 25-hydroxyvitamin D

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17
Q

Vitamin E

A

AKA Tocopherols
Vision, reproduction, health of blood/brain/skin, cell membrane protection

Deficiency: neuropathy, RBC hemolysis in malnourished infants

Excess: ow toxicity, augments anticoagulant effects

Sources: salad oil, shortenings, margarine, whole grain, legumes, nuts, dark leafy veggies

RDA: 15mg/day

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18
Q

Vitamin K

A

Forms PT, synthesized in intestines, neg. effected by antibiotics

Deficiency: prolonged clotting time, heme (esp in newborns)

Excess: toxic in large amounts

Sources: intestinal bacteria, dark leafy veggies

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19
Q

Vitamin C

A

Forms collagen, hormone synthesis, teeth firm in gums, infection resistance, iron absorption

Deficiency:poor wound healing, poor bone/tooth development, dry skin, petechiae, fatigue, scurvy

Excess: kidney stones, false neg urinary glucose in DM

Sources: citrus, strawberries, cantaloupe, tomatoes, broccoli, raw green veggies, potatoes, peppers

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20
Q

Vitami B1-Thiamine

A

Coenzyme for glucose breakdown, healthy nerves, good digestion, normal appetite

Deficiency: neuropathy, Wernicke encephalopathy (eye probs), beriberi disease (nerve inflammation)

Source: meats, dry beans/peas, PB, enriched whole grain bread, milk, eggs

If pt presenting w/ encephalopathy/alcoholis treat w/ thiamine

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21
Q

Vitamin B2- Riboflavin

A

Coenzymes for proteins/glucose metabolism, fatty acid synthesis, electron transporter

Deficiency: Cheilitis, burning/itchy/sensitive eyes, glossitis/scarlet tongue

Sources: dairy, meat, fish, leafy veggies, enriched/whole grain breads, cereal

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22
Q

Vitamin B3-Niacin

A

Required by all cells, coenzyme for energy metabolism, needed for RNA/DNA formation, normal digestion, healthy skin/nervous system
Tryptophan is precursor (60mg=1mg niacin)

Deficiency: Pellagra (dermatitis, hyper pigmentation, glossitis), birth defects

Excess: flush/itchy/tingly, liver failure, DM, gout, hypotension, peptic ulcer disease

Sources: meat, fish, leafy veggies, enriched, cereal, supplements

Benefits: release fatty acids, reduce cholesterol, replacement for statins in high dose

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23
Q

Vitamin B5-Pantothenic Acid

A

Coenzyme A
Synthesizes sterols, fatty acids, heme

Deficiency (rare): neuritis of limbs, burning feet, vomitting

Sources: meat, fish, legumes, whole grain cereal, milk, fruit, veggies, colonic bacteria

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24
Q

Vitamin B6-Pyridoxine

A

Coenzymes for protein metabolism
Conversion of tryptophan to niacin, formation of heme

Deficiency (rare): cheilosis, anemia, stomatitis, weak gait, irritability/insomnia, nasolabial seborrheic dermatitis

Excess: peripheral neuropathy, photosensitivity, nausea

Sources: meat, whole grain, leafy veggies, potatoes

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25
Vitamin B12
Formation of mature RBC, synthesis of DNA/RNA, requires intrinsic factor from stomach for absorption Deficiency: pernicious anemia, microcytic anemia, neurologic degeneration, pallor Sources: animal foods, milk, eggs, meat, fish
26
Vitamin-Folate, folic acid
Maturation of RBC, synthesis of DNA, RNA Deficiency: microcytic anemia (need supplements in pregnancy) Sources: dark leafy veggies, meat, fish, eggs, flour, whole grain cereal, citrus fruit
27
Vitamin Biotin
Components of coenzymes in metabolism, synthesis in intestine, avidin interferes with absorption Deficiency: AMS, Myalgia, anorexia/nausea, dermatitis around eyes, alopecia Sources: organ meats, egg yolk, legumes, nuts, yeast, mushrooms
28
Macrominerals
Calcium, phosphorous, potassium, magnesium, sodium
29
Microminerals
Iron, iodine, copper, zinc, fluoride
30
Calcium
99% found in bones/teeth, nervous stimulation, muscle contraction, blood clotting, activates pancreatic lipase, PTH regulates blood levels, 10-40% absorbed, aided by vit D and lactose, hindered by oxalic acid RDA:1000mg/day deficiency: fragile bones, osteoporosis, hypertension Sources: dairy, mustard/turnip greens, cabbage, broccoli, clams, oysters, salmon, fortified foods, juice, rice, cereal
31
Phosphorous
80-90% in bones/teeth, aides in tissue/cell repair, assist kidneys ridding waste, reduce muscle pain after strenuous activities, enzymes for energy metabolism, protein synthesis, regulation of heart rate, conduction of nerves Deficiency: bone pain, fatigue Excess: hard organs/muscles/soft tissue, interferes with body use of iron, mg and zinc, happens in renal disease, need to balance with calcium Sources: dairy, meat, fish, whole grain, nuts, legumes RDA: 700mg/day
32
Magnesium
60%in bones/teeth, helps bones stay strong, transmits nerve impulses, muscle contraction, enzymes for energy metabolism, supports healthy immune system, regulates HR, assist in regulating BS Deficiency: weakness, irritability, irregular heart beat Sources:milk, meat, leafy veggies, legumes, whole grain RDA 250-300mg/day
33
Sodium
Extracellular fluid, water/acid-base balance, nervous stimulation, muscle contraction, regulated by adrenals, excreted in urine and skin Deficiency: rare, excessive sweating Excess: hypertension Source: salt, baking powder/soda, milk, eggs, meat, fish, process/cured/smoked food <2300mg/day
34
Potassium
Intracellular fluid, protein/glycogen synthesis, water balance, transmits nerve impulses, muscle contraction, regulated by adrenals, excreted in urine Deficiency: starvation, diuretic, GI losses, aldosteronism, DM ketoacidosis, CKD, excess alcohol use Fatigue, muscle cramps, constipation Sources: meat, cereal, fruit/juice, veggies, molasses, salt substitute Causes of excess: kidney failure, CKD, Addison's disease, angiotensin II receptor blockers, ACE inhibitors, beta blockers, dehydration, RBC destruction, type 1 DM
35
Iron
in Hgb, muscle myoglobin, oxidizing enzymes for release of energy, acid/vitamin c aid absorption, daily loss in urine/feces, menstrual loss Deficiency: anemia, cheiosis, pallor Excess: vommiting, diarrhea, altered consciousness, hepatotoxicity, death Sources: organ meat, fish, whole grain, green veggies, dried fruit
36
Iodine
Forms thyroxine for energy metabolism, in thyroid gland Deficiency: Goiter Sources: iodized salt, shellfish, saltwater fish
37
Fluoride
Prevents tooth decay, stored in bones/teeth Excess: leads to tooth mottling Sources: fluoridated water/toothpaste
38
Zinc
Enzymes for tx of co2, taste/protein synthesis, necessary for insulin formation Deficiency: growth retardation, altered taste, depressed immunity, acrodermatitis enteropathica Sources: plant/animal proteins, oysters
39
Copper
Uses iron for Hgb formation, pigment formation, myelin sheath, healthy bones/collagen, ceruloplasmin in blood, necessary for insulin formation Deficiency: rare, decreased with excess zinc Excess: Wilsons disease Sources: liver, meat, shellfish, nuts, legumes, whole grain cereal
40
Fruit
Vit c, fiber, potassium
41
Veggies
fiber, potassium, Vitamins A, C, K, E, B6, copper, meg, thiamine, niacin, choline, folate
42
Grains
fiber, iron,zonc, manganese, folate, mag, copper, thiamine, niacin, vit B6/A, phosphate, selenium, riboflavin
43
Dairy
Calcium, phos, vit A/D/B12, riboflavin, protein, potassium, zinc, choline, mag, selenium
44
Protein
B vitamins, selenium, choline, phos, zinc, copper, Vit D/E
45
Oils
Essential fatty acids and VitaminE
46
Physical Activity Coefficient (PAC)
sedentary: 1 Low active: 1.12 Active: 1.27 Very active: 1.45
47
How many calories in 1 pound?
3500
48
Carbs
Digestd into glucose, increases BS, main fuel source 225-325 g/day (900-1300cals/day from carbs, 1 carbs=15g) Glycemic index: low 1-55, medium 56-69, high >69
49
Fat
Energy reserve, protects organs, insulation, transports fat soluble vitamins
50
Fats-oils
in plant/aanimals supply calories assist in absorption of vit A, D, E, K Health benefits
51
Essentail Fats
Needed to build cell membranes, used for maintaining nerve sheaths, blood clotting, muscle movement, inflammation
52
Polyunsaturated Fats
Essential for normal function Omega 3: seafood, flax seed/walnuts, soybean/canola oil Omega 6: safflower, soybean, sunflower, walnut and corn oils Lower LDL/triglycerides FDA RDA: <2g/day AHA RDA 2-4g/day under care
53
Monounsaturated Fatty Acid
No RDA Lowers bad cholesterol when replacing saturated fats (olive, peanut, sunflower, etc oils) Mediterranean diet
54
Saturated Fatty Acids
Can contribute to increased LDL, recommended <10% of daily calories/day Coconut, palm kernel, butter, palm oil
55
Trans Fatty Acids
Poor health effects (increase LDL, decrease HDL) Inflammatory effects Contributes to insulin resistance Banned inUS
56
Protein
Tissue structure, part of cell plasma membranes, involved metabolic/transport /hormone systems, make up enzymes that regulate metabolism Acid-base balance Legumes, lentils, soy, peanuts, whole grains, seeds, meat, veggies 0.8g/kg of body weight/day
57
Fiber
RDA 25-36g/day | Benefits: decreased risk of heart disease/DM, lowers risk of colorectal cancer, decreased all-cause mortality
58
Low carb/keto diet
4 parts fat:1part protein Should starts MVI, calcium potassium citrate and vit D supplements Lots of adverse effects
59
Low Carb Diet
Short term weight loss | 60-130g (avg is 225-325)
60
Low Fat diet
limited to <30% of energy intake Fat=9.4cls/g best for long term weight loss
61
High protein diet
Suggested for obese (curbs appetite) | help improve weight maintenance
62
Very low cal diets
Energy level 200-800cal/day rapid weight loss not suggested for obese/not conventional Used to prep for sx Adverse effects: hair loss, thin skin, cold, increased risk of gallstones

Foundations (10 decks)

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